[Innovations in defered emergency surgery for complete rupture of the membranous uretra]

Posterior urethral injuries may be associated with pelvic fractures, which are serious accidents that can be life-threatening, and invariably affect urinary and sexual function. Current strategy for treating complete rupture of the membranous urethra involves minimal cystotomy with emergency surgery within the first 10 days, this is later followed by what is considered to be the ideal solution, end-to-end urethral anastomosis using the transpubic approach. However, this anatomic reconstruction is hindered by the greatdifficulty of locating the distal portion of the uretra below the superior layer of the medial perineal aponeurosis. As we described, this problem is resolved using a maneuver involving elevation of the urogenital diaphragm, which allows for the indentification and exposure of the distal urethra, facilitating tension-free termino-terminal anastomosis, sparing the external sphincter.